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Individual

HEIDI L GANZER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.D.

Contact information

Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407
(612) 863-0200
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1070
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1609837848
MN
01
2375591
AMERICA'S PPO
MN
01
363G5GA
BLUE CROSS BLUE SHIELD MN
MN
01
6300266
MEDICA
MN
Enumeration date
03/29/2006
Last updated
11/22/2019
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